HomeMy WebLinkAboutMortgage_WeagleySTATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS coun
_ FOR DEDUCTION FROM ASSESSED VALUATION
' smce wnn a3�os �„ i s-os�
ti � Prewibed M �ePeNneM o( Lod Govamrtrerrt Fumnce
INSTRUCTIONS: -
To be filed in person w 6y mail wiN the CountyAuditor w Counry RecoNer o/ the counry where fhe pmperty is located.
Fitirg Dates: 1J Real Property: Must file durirg Ne year for which the deduction is sought.
2) Mo6de / Manu/aUwed Homes rrot assessed as Real Properly: Must file dunng Me twelve (12J months
be(ore MarcA 37 of each year the deduction is swght.
See 2verse side for addifional instructnons arM quelifications.
AsesseC vd4ie c( re� P�Y a of
MazCh 1. amnt year
(
tt m. what ts h"s / her ezae share ot Nterest?
�M�ortapag -��-�03-
Mert�h 1, aaContrarl iMebtednrs
To�`C� 0 C
M nama on ieaxE o Oitteren� Nan tt�at ot app0on; 6Mipte bebw.
Nart�e oi rtqf�gea or
rtprtgagee or contract snAer (nwnber and street �:
signee w ottrel owner or halder d morigage
PdE�ass ol assignee (number and shee( ciry, stefe, entlllP cotle)
Dces a�nt v«n poperty in any other
munry in Ind'ana7 f-1 .,' _
�
Sgrenne d Ca�mb aiOitcr
I / We certty urn
oHp,er � c«,aaa
20 _
yes. what county+
20 � 20
� �ai _
aate
M/� 6c���1D��
❑ Counry Recorder
GIBSON
unOaN a of I is Ne app�cant Me sde
legal a epuitable w/nM
❑ Yes ❑ No
rcwrtnd with wmew�a WierUian spouse. mdimle wflh �M�wn
Is Ihe property in Question: Mnualty PssesseE
❑ Real Property ❑ Armually Assessed
' �o ao�.b '«�°�
DCa11'Cl' � ................... s ❑ No
_. .� , .
U . '
' Cat'd NO. .....'l� ip
_ . . .........
� � 3,ocn.ao
_ � N_ � �_
�ate (rtpnth. daY• Y��
ry oi perjyfy that Ne above and foregoing infom�aUon is true and cortect arW that the applirant is a resident of Indiana arwl
aforemenboned property on date appliption is fileE.
� � _ „ o-ate (nanm. aay, yne�
m nu�,ey
Pdtlresa o( auCnrtreE Ce�^ (numGe� erd sfreet �'4Y. state. antl